Can you take Bitolterol with Phenylephrine topical?
1 drug interaction and 13 additional warnings found for the following 2 drugs:
- bitolterol
- phenylephrine topical
Drug interactions
Moderate drug interactions
Moderate:
bitolterol phenylephrine topical
Applies to: bitolterol and phenylephrine topical
Using bitolterol together with phenylephrine topical may increase cardiovascular side effects such as elevations in heart rate and blood pressure or irregular heart rhythm.
Talk to your doctor if you have any questions or concerns, particularly if you have a history of high blood pressure, arrhythmia, or heart disease.
Your doctor may be able to prescribe alternatives that do not interact, or you may need a dose adjustment or more frequent monitoring to safely use both medications.
It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.
Food/lifestyle interactions
Moderate food/lifestyle interactions
Moderate:
bitolterol Caffeine
Applies to: bitolterol
Both bitolterol and caffeine can increase blood pressure and heart rate, and combining them may enhance these effects.
Talk to your doctor before using these medications, especially if you have a history of high blood pressure or heart disease. You may need a dose adjustment or more frequent monitoring by your doctor to safely use both medications.
Contact your doctor if your condition changes or you experience increased side effects.
It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.
Disease interactions
12 potential interactions Applies to: 10 conditions, including High Blood Pressure, Benign Prostatic Hyperplasia, Seizures, Hypokalemia, and Hyperthyroidism.
Benign Prostatic Hyperplasia
Moderate:
phenylephrine topical
Phenylephrine topical has a moderate potential interaction with Benign Prostatic Hyperplasia.
Topically applied sympathomimetic agents are systemically absorbed, with the potential for producing clinically significant systemic effects, particularly during prolonged or indiscriminate use. In patients with prostate enlargement, urinary difficulty may develop or worsen due to smooth muscle contraction in the bladder neck via stimulation of alpha-1 adrenergic receptors. Therapy with topical sympathomimetic agents should be administered cautiously in patients with hypertrophy or neoplasm of the prostate. It is important that the recommended dosages of the individual products not be exceeded.
Cardiovascular Conditions and Disorders
Moderate:
phenylephrine topical
Phenylephrine topical has a moderate potential interaction with Cardiovascular Conditions and Disorders.
Topically applied sympathomimetic agents are systemically absorbed, with the potential for producing clinically significant systemic effects, particularly during prolonged or indiscriminate use. In cardiac tissues, these agents may produce positive chronotropic and inotropic effects via stimulation of beta-1 adrenergic receptors. Cardiac output, oxygen consumption, and the work of the heart may be increased. In the peripheral vasculature, vasoconstriction may occur via stimulation of alpha-1 adrenergic receptors. The use of topical sympathomimetic agents has rarely been associated with palpitations, tachycardia, arrhythmia, hypertension, reflex bradycardia, and coronary occlusion. Therapy with topical sympathomimetic agents should be administered cautiously in patients with sensitivity to sympathomimetic amines, hyperthyroidism, or underlying cardiovascular or cerebrovascular disorders, especially coronary insufficiency, cardiac arrhythmia, or hypertension.
Cerebrovascular Insufficiency
Moderate:
phenylephrine topical
Phenylephrine topical has a moderate potential interaction with Cerebrovascular Insufficiency.
Topically applied sympathomimetic agents are systemically absorbed, with the potential for producing clinically significant systemic effects, particularly during prolonged or indiscriminate use. In cardiac tissues, these agents may produce positive chronotropic and inotropic effects via stimulation of beta-1 adrenergic receptors. Cardiac output, oxygen consumption, and the work of the heart may be increased. In the peripheral vasculature, vasoconstriction may occur via stimulation of alpha-1 adrenergic receptors. The use of topical sympathomimetic agents has rarely been associated with palpitations, tachycardia, arrhythmia, hypertension, reflex bradycardia, and coronary occlusion. Therapy with topical sympathomimetic agents should be administered cautiously in patients with sensitivity to sympathomimetic amines, hyperthyroidism, or underlying cardiovascular or cerebrovascular disorders, especially coronary insufficiency, cardiac arrhythmia, or hypertension.
Diabetes Mellitus
Moderate:
bitolterol
Bitolterol has a moderate potential interaction with Diabetes Mellitus.
Adrenergic bronchodilators may cause increases in blood glucose concentrations. These effects are usually transient and slight, but may be significant with dosages higher than those normally recommended. Large doses of IV albuterol (not commercially available in the U.S.) and terbutaline sulfate have been reported to cause exacerbation of preexisting diabetes mellitus and ketoacidosis. Therapy with adrenergic bronchodilators should be administered cautiously in patients with diabetes mellitus. Closer monitoring of blood glucose concentrations may be appropriate. Systemic adverse effects are minimized, but not abolished, by administration of these agents via oral inhalation.
Moderate:
phenylephrine topical
Phenylephrine topical has a moderate potential interaction with Diabetes Mellitus.
Topically applied sympathomimetic agents are systemically absorbed, particularly during prolonged or indiscriminate use. Slight increases in blood glucose concentrations may occur with the use of these drugs. Therapy with topical sympathomimetic agents should be administered cautiously in patients with diabetes mellitus. Closer monitoring of blood glucose concentrations may be appropriate. It is important that the recommended dosages of the individual products not be exceeded.
Heart Disease
Moderate:
bitolterol
Bitolterol has a moderate potential interaction with Heart Disease.
Adrenergic bronchodilators can stimulate cardiovascular beta- 1 and beta- 2 receptors, resulting in adverse effects such as tachycardia, palpitation, peripheral vasodilation, blood pressure changes, and ECG changes (e.g., flattening of the T wave; prolongation of the QT interval; ST segment depression). Direct stimulation of cardiac tissues is mediated by beta- 1 receptors and thus less likely to occur with beta-2-selective agents such as albuterol. However, beta-2-selectivity is not absolute and can be lost with larger doses. High dosages of these agents have been associated with precipitation or aggravation of angina, myocardial ischemia, and cardiac arrhythmias. Therapy with adrenergic bronchodilators should be administered cautiously in patients with sensitivity to sympathomimetic amines, hyperthyroidism, and/or underlying cardiovascular disorders such as coronary insufficiency, cardiac arrhythmias, or hypertension. The recommended dosages should not be exceeded.
High Blood Pressure
Moderate:
bitolterol
Bitolterol has a moderate potential interaction with High Blood Pressure.
Adrenergic bronchodilators can stimulate cardiovascular beta- 1 and beta- 2 receptors, resulting in adverse effects such as tachycardia, palpitation, peripheral vasodilation, blood pressure changes, and ECG changes (e.g., flattening of the T wave; prolongation of the QT interval; ST segment depression). Direct stimulation of cardiac tissues is mediated by beta- 1 receptors and thus less likely to occur with beta-2-selective agents such as albuterol. However, beta-2-selectivity is not absolute and can be lost with larger doses. High dosages of these agents have been associated with precipitation or aggravation of angina, myocardial ischemia, and cardiac arrhythmias. Therapy with adrenergic bronchodilators should be administered cautiously in patients with sensitivity to sympathomimetic amines, hyperthyroidism, and/or underlying cardiovascular disorders such as coronary insufficiency, cardiac arrhythmias, or hypertension. The recommended dosages should not be exceeded.
Hyperthyroidism
Moderate:
bitolterol
Bitolterol has a moderate potential interaction with Hyperthyroidism.
Adrenergic bronchodilators can stimulate cardiovascular beta- 1 and beta- 2 receptors, resulting in adverse effects such as tachycardia, palpitation, peripheral vasodilation, blood pressure changes, and ECG changes (e.g., flattening of the T wave; prolongation of the QT interval; ST segment depression). Direct stimulation of cardiac tissues is mediated by beta- 1 receptors and thus less likely to occur with beta-2-selective agents such as albuterol. However, beta-2-selectivity is not absolute and can be lost with larger doses. High dosages of these agents have been associated with precipitation or aggravation of angina, myocardial ischemia, and cardiac arrhythmias. Therapy with adrenergic bronchodilators should be administered cautiously in patients with sensitivity to sympathomimetic amines, hyperthyroidism, and/or underlying cardiovascular disorders such as coronary insufficiency, cardiac arrhythmias, or hypertension. The recommended dosages should not be exceeded.
Moderate:
phenylephrine topical
Phenylephrine topical has a moderate potential interaction with Hyperthyroidism.
Topically applied sympathomimetic agents are systemically absorbed, with the potential for producing clinically significant systemic effects, particularly during prolonged or indiscriminate use. In cardiac tissues, these agents may produce positive chronotropic and inotropic effects via stimulation of beta-1 adrenergic receptors. Cardiac output, oxygen consumption, and the work of the heart may be increased. In the peripheral vasculature, vasoconstriction may occur via stimulation of alpha-1 adrenergic receptors. The use of topical sympathomimetic agents has rarely been associated with palpitations, tachycardia, arrhythmia, hypertension, reflex bradycardia, and coronary occlusion. Therapy with topical sympathomimetic agents should be administered cautiously in patients with sensitivity to sympathomimetic amines, hyperthyroidism, or underlying cardiovascular or cerebrovascular disorders, especially coronary insufficiency, cardiac arrhythmia, or hypertension.
Hypokalemia
Moderate:
bitolterol
Bitolterol has a moderate potential interaction with Hypokalemia.
Adrenergic bronchodilators may cause decreases in serum potassium concentrations, primarily when given by nebulization or intravenous administration. Although this effect is usually transient and does not require supplementation, clinically significant hypokalemia may occur in some patients, with the potential to induce cardiovascular adverse effects. The relevance of these observations to oral or oral aerosol/powder for inhalation therapy is unknown. Therapy with adrenergic bronchodilators should be administered cautiously in patients with or predisposed to hypokalemia.
Prostate Tumor, Benign
Moderate:
phenylephrine topical
Phenylephrine topical has a moderate potential interaction with Prostate Tumor, Benign.
Topically applied sympathomimetic agents are systemically absorbed, with the potential for producing clinically significant systemic effects, particularly during prolonged or indiscriminate use. In patients with prostate enlargement, urinary difficulty may develop or worsen due to smooth muscle contraction in the bladder neck via stimulation of alpha-1 adrenergic receptors. Therapy with topical sympathomimetic agents should be administered cautiously in patients with hypertrophy or neoplasm of the prostate. It is important that the recommended dosages of the individual products not be exceeded.
Seizures
Moderate:
bitolterol
Bitolterol has a moderate potential interaction with Seizures.
Adrenergic bronchodilators may cause CNS stimulation. Therapy with adrenergic bronchodilators should be administered cautiously in patients with seizure disorders. Systemic adverse effects are minimized, but not abolished, by administration of these agents via oral inhalation.
More resources
bitolterol
A total of 396 drugs are known to interact with bitolterol.
- Bitolterol is in the drug class adrenergic bronchodilators.
- Bitolterol is used to treat the following conditions:
phenylephrine topical
A total of 197 drugs are known to interact with phenylephrine topical.
- Phenylephrine topical is in the drug class anorectal preparations.
- Phenylephrine topical is used to treat the following conditions:
Drug Interaction Classification
| Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit. | |
| Moderately clinically significant. Usually avoid combinations; use it only under special circumstances. | |
| Minimally clinically significant. Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan. | |
| No interaction information available. |
Further information
Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.